The App Helping Africa’s Midwives Save Lives

This article first appeared on the Women & Girls Hub from News Deeply

A mobile health project in Ethiopia gives any health worker with a smartphone access to the information they need to deal with emergencies during childbirth. Now it’s being scaled up to reach 10,000 health workers across Africa and Southeast Asia by 2017.

A midwife at Gimbi Health Center in West Wellega, Ethiopia, uses the Safe Delivery App to help her carry out an examination on a patient. Photo by Mulugeta Wolde

For Ethiopian mother Mitike Birhanu, the birth of her twins almost ended in tragedy. She was unconscious when the second of her babies was delivered, and the newborn seemed lifeless. But her midwife quickly consulted an app on her smartphone, diagnosed the problems, and used emergency procedures to save both Mitike’s life and that of her child.

Every year, over 300,000 women globally die from pregnancy-related causes, and over 5 million babies die during birth or within the first weeks of their lives. Yet the vast majority of maternal and newborn deaths could be prevented if health workers attending births had better emergency skills and knowledge.

Many health workers in low- or middle-income countries work in environments where there is no electricity or running water. But one thing they do have is smartphones.

The Safe Delivery App (SDA) was created as a simple tool for health workers such as midwives and nurses to access basic emergency obstetric and neonatal care skills. Developed by Danish NGO Maternity Foundation in collaboration with the University of Southern Denmark and the University of Copenhagen, the app aims to train and instruct birth attendants on how to manage potentially fatal complications during pregnancy and childbirth.

Based on global clinical guidelines, the SDA contains four basic features: animated instruction videos, action cards, a drug list and practical procedure instructions. The five- to seven-minute videos teach lifesaving skills such as how to stop a woman bleeding after birth or how to resuscitate a newborn. When there is no time to watch the full video, the action cards give clear, essential recommendations and immediate care information – such as how to mix an alcohol-based hand rub.

The SDA is free to download from Google Play and the App Store. And it can be preinstalled on phones, so once it’s downloaded, users don’t need a network connection or internet access to view the videos or other features.

Meaza Semaw, project coordinator at the Ethiopian Midwives Association, says the app is ideal for places like Ethiopia, where women’s access to quality maternal health services is challenging, especially if they experience complications in birth. “The Safe Delivery App is a great tool to improve maternal health in Ethiopia. Most midwives, if not all, have a mobile phone, so accessibility is very high,” she says. “The app is easy to use because it is supported by animations and videos. In addition, it uses local languages.”

With the support of the MSD for Mothers program, the first four of the app’s 10 videos were tested in a one-year, randomized controlled trial across 78 facilities in Ethiopia during 2014. Results show users’ skills in handling most common complications such as postpartum hemorrhage and newborn resuscitation more than doubled after 12 months of using the app.

The app was officially launched in April 2015, and a year later was chosen by the Women Deliver conference as an example of how a partnership-based innovation can help end maternal and newborn mortality. SDA is now currently in use in Kenya, with plans to roll out to Guinea, Sierra Leone, Myanmar, Laos and India in the coming months.

So far, the app has been funded with help from over $50,000 in donations through an Indiegogo crowdfunding campaign, and Maternity Foundation is working with partners in individual countries to fund the translation and rollout of the app. The hope is to be able to fulfill the commitment Maternity Foundation made to the U.N.’s Every Woman Every Child to reach 10,000 health workers with the app by the end of 2017, so ensuring a safer birth for 1 million women.

At Wollega University in Ethiopia, student midwives use the app during training. (Mulugeta Wolde)At Wollega University in Ethiopia, student midwives use the app during training. (Mulugeta Wolde)

Maternity Foundation CEO Anna Frellsen says the organization is working in partnership with governments, midwives’ associations and larger NGOs to achieve its goal. “We really want to see the app integrated as part of the existing health system in countries, and we are starting to engage with the [health] ministries and stakeholders in each country to find out how it can be used and adapted,” she says.

The Ethiopian Midwives Association is currently working on integrating the SDA into its ongoing training program. Frellsen hopes other health organizations in participating countries will do likewise.

There is also a new version of the app in the works, which will feature quizzes and a test (rewarded by a certificate) to “push” learning to the user and make the experience more interactive.

Frellsen says one of the key components of Maternity Foundation’s “backbone” support for its partners will be disseminating learning around the SDA and mobile health in general. “We are looking at how we can publish some of the learning for sharing with others who would like to use the app, but also more broadly as a case for how to scale up an mHealth [mobile health] tool,” she says.

In western Ethiopia’s Gimbi rural district, the midwife who saved Mitike’s life says the Safe Delivery App has already made her better at her job. “I am confident that from what I have learned from the app, I can stop [a mother] bleeding,” says Yane Ababaw. “I can save her life.”

A Future in Code: Building Life Skills in Syria

This article first appeared on the Women & Girls Hub from News Deeply

Motivated by a desire to rebuild Syria’s devastated economy, enterprising young women in the war-torn country are turning to tech to help others of their generation find employment – and better futures.

Leen Darwish, right, developed her Arabic-language platform Remmaz to address the gap in non-English-language programming resources that are available to Arab communities. Photo by UNFPA Syria/Ghassan Ahmad

 

For the past five years, 22-year-old Syrian student Leen Darwish has seen her country ruined by bombings, battles and one of the biggest population displacements in modern history. But determined to help rebuild the nation’s economy for her fellow young people, Darwish – a computer science undergraduate at the University of Damascus – has launched an award-winning, Arabic-language app to help young people in Syria, and beyond, learn to code.

Just six months since its launch, Darwish’s Remmaz app already has over 5,000 active users learning to code, design websites and develop apps (application programs) on the platform she and her business partner started developing while they were second-year university students. Their aim is to create an accessible, Arabic online learning MOOC (massive open online course) to address the lack of non-English programming resources available to Arab communities, particularly young people looking for employment in conflict-scarred Syria.

Darwish and her team are in the process of crunching the data to find out more about Remmaz’s users. However, they already know that most are based in Morocco and aged between 20 and 23 – university-age students looking for work opportunities, she suggests.

“Remmaz is a startup whose mission is to make an evolution in online learning about programming in the Arab world, to empower people to learn about cutting-edge technology tools through Arabic content, in an easy and accessible way, to let them be qualified for a job opportunity in one of the highest-paid jobs – programming,” says Darwish.

The conflict in Syria has created 5 million refugees and internally displaced a further 13.5 million residents – a total of 18.5 million people forced from their homes in a country that, before the conflict began, had a population of 23 million. Secondary education has dropped by 44 percent, causing an estimated economic loss of over $10 billion – equivalent to nearly 18 percent of the national GDP.

Darwish launched Remmaz after attending a three-week training course in December 2015, supported by the UNFPA’s Innovation Fund, on how to start and manage a small business. She initially heard about the course through her startup incubator. Having developed her idea, she was keen to gain some commercial skills and make contacts.

“I began my startup when I was in the second year of university, so I lacked business knowledge and entrepreneurship culture,” she says, speaking from her adopted city of Damascus; she left her home town of Harasta when the conflict made it untenable for her family to remain there. “This program was a great opportunity, as the mentors and trainers have 20 years of real experience in this field, which was really important for me.”

People taking part in the UNFPA (United Nations Population Fund) program, run in partnership with local NGOs, ranged from 22 to 30 years of age and came from different ethnic groups and regions. Like Darwish, they had been displaced by the conflict in Syria. Nearly 200 people applied for 28 places; 20 of the 28 were women.

Through lectures, workshops and mentoring, participants were supported as they worked to fine-tune their plans and develop their tech-based small businesses. Delivered by enterprise experts, the training covered marketing, accounting, business planning, communications and leadership skills.

At the end of the course, 17 projects were chosen for further UNFPA support. Along with Remmaz, they included computer maintenance, after-school programs and online computer games. More recently, Remmaz won an entrepreneurship competition for Syrian startups, taking a $15,000 prize that will go towards expanding the app, says Darwish.

Bruce Campbell, UNFPA global coordinator for the organization’s Data for Development platform, says the program helps “to improve the resilience of Syrian young people by supporting them with critical life skills and strengthening their ability to cope with difficult circumstances.”

But he acknowledges that the program has had its challenges, from the high volume of applicants to the limited ability to travel throughout the country, making it difficult to expand the project.

Of the 28 students on the UNFPA's startup training course, 20 were women. (UNFPA Syria)Of the 28 students on the UNFPA’s startup training course, 20 were women. (UNFPA Syria/Ghassan Ahmad)

Based on the innovation program’s success in Damascus, UNFPA has since rolled out the training to two more Syrian governorates, Homs and Tartous. Campbell hopes it will continue to scale up in Syria, with the ambition of rolling out the program over two years.

“The program encourages young people to submit projects jointly, supporting them to become comfortable working together across ethnic divisions,” he says. “For example, it would not be uncommon to see young people from Aleppo sending textiles to youth in Tartous, and young people from Tartous sending IT equipment to counterparts in Aleppo.”

After graduation this summer, Darwish plans to take a master’s degree in artificial intelligence and organize “hackathons” in collaboration with UNFPA and Damascus Girl Geeks. But she remains focused on her vision for Syria. “Big businesses are closing and the problems we are facing only young people can solve,” she says. “The need for startups and entrepreneurship culture is really essential for Syria.”